Tackling antimicrobial resistance: an AWaRe-based intervention for acute respiratory illness in primary care for low- and middle-income countries
1
Clinical Content, Knowledge Translation Foundation, Cape Town, South Africa
2
Innovation, Knowledge Translation Foundation, Cape Town, South Africa
3
Learning and Development, Knowledge Translation Foundation, Cape Town, South Africa
4
Implementation, Knowledge Translation Foundation, Cape Town, South Africa
5
Design, Knowledge Translation Foundation, Cape Town, South Africa
6
Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, Northampton Square, United Kingdom
7
Public Health, University of East Anglia, Norwich, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
ABSTRACT:
Background - About 90% of antibiotics prescribed for humans occurs in primary care, and most are inappropriate, contributing to global antimicrobial resistance (AMR)(1). To promote safer antibiotic use, the World Health Organisations (WHO) AWaRe system categorises antibiotics into Access, Watch and Reserve groups(1). The AWaRe1 trial(2) focusses on common acute respiratory illnesses (ARIs) in four low- and middle-income countries (LMICs) – Nigeria, Indonesia, Bangladesh, and Vietnam – and aims to improve antibiotic use by changing health worker prescribing behaviours using an AWaRe-based intervention. Methods – Content from the 2022 WHO AWaRe antibiotic book(1) guided the development of an intervention package, including tools and training. Algorithmic approaches to four common ARI presentations (sore throat, sore ear, sore face and new cough) in adults and children aged 1-12 years include key messages around antibiotic use. This informed an educational outreach approach to deliver training sessions to health workers by local champions, guided by the COM-B behaviour change model(3). Workshops with stakeholders from the WHO AMR Division ensured clinical accuracy and alignment with the AWaRe book1. An internal pilot assessed and improved content flow and ease of usability, and the intervention was aligned to AWaRe branding. Results – The intervention comprises a clinical decision support tool, four behaviour change posters, a self-audit log for health workers, a one-page clinical summary to help diagnose ARIs, and a training package comprising case studies, slides and quizzes linked to a reporting system. It is ready for localisation to the four trial countries to reflect local policy and guidelines, available resources, and cultural norms. Conclusion – This intervention provides a template for an educational strategy for the AWaRe system to support appropriate antibiotic prescribing for ARIs in LMIC primary care. Following evaluation, it may be optimised to be expanded to other clinical presentations and to other LMICs.
Background - About 90% of antibiotics prescribed for humans occurs in primary care, and most are inappropriate, contributing to global antimicrobial resistance (AMR)(1). To promote safer antibiotic use, the World Health Organisations (WHO) AWaRe system categorises antibiotics into Access, Watch and Reserve groups(1). The AWaRe1 trial(2) focusses on common acute respiratory illnesses (ARIs) in four low- and middle-income countries (LMICs) – Nigeria, Indonesia, Bangladesh, and Vietnam – and aims to improve antibiotic use by changing health worker prescribing behaviours using an AWaRe-based intervention. Methods – Content from the 2022 WHO AWaRe antibiotic book(1) guided the development of an intervention package, including tools and training. Algorithmic approaches to four common ARI presentations (sore throat, sore ear, sore face and new cough) in adults and children aged 1-12 years include key messages around antibiotic use. This informed an educational outreach approach to deliver training sessions to health workers by local champions, guided by the COM-B behaviour change model(3). Workshops with stakeholders from the WHO AMR Division ensured clinical accuracy and alignment with the AWaRe book1. An internal pilot assessed and improved content flow and ease of usability, and the intervention was aligned to AWaRe branding. Results – The intervention comprises a clinical decision support tool, four behaviour change posters, a self-audit log for health workers, a one-page clinical summary to help diagnose ARIs, and a training package comprising case studies, slides and quizzes linked to a reporting system. It is ready for localisation to the four trial countries to reflect local policy and guidelines, available resources, and cultural norms. Conclusion – This intervention provides a template for an educational strategy for the AWaRe system to support appropriate antibiotic prescribing for ARIs in LMIC primary care. Following evaluation, it may be optimised to be expanded to other clinical presentations and to other LMICs.
| eISSN: | 2654-1459 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
